Should statins be used to prevent cardiovascular disease in patients on hemodialysis?

There now exists current evidence that the initiation of statin therapy in patients on hemodialysis does not provide the same cardiovascular benefit as in non-hemodialysis patients. The KDIGO guidelines suggest not to initiate statin therapy in hemodialysis-dependent CKD patients, but to continue therapy in patients who are already on a statin at the time of hemodialysis initiation. A closer monitoring of myopathy is warranted for hemodialysis patients on a statin therapy.